AB0726 Study of the association of various X-ray symptoms of interstitial lung disease (ILD) in patients with systemic scleroderma(SSc) with indices of lung functional tests.
Authors: O. Koneva, L. Garzanova, O. Ovsyannikova, N. Kovaleva, L. P. Ananyeva, O. Desinova, M. Starovoytova, R. Shayakhmetova
Journal: Annals of the Rheumatic Diseases (2022)

Background HRCT is the gold standard for confirming the presence of ILD. According to the literature data,there is an association between the prevalence of pulmonary involvement and the severity of PFTs.However,it remains unclear whether the nature of interstitial changes affects the degree of PFTs. Objectives To study the clinical significance of various X-ray symptoms in SSc-ILD during long-term follow-up. Methods The study included 37 pts with a SSc-ILD(average age-53.1±11.5 yrs, m/w- ¼, and d/l–1/1.8, SSc duration-10.9±9 yrs).For all pts at the time of inclusion in the study and after an average of 34±2.3 months,there were examined FVC,DLC,HRCT.All pts received immunosuppressive therapy(IST). The analysis of HRCT data was conducted at 5 levels.The severity of changes by type of ground-glass,reticular changes,traction bronchiectases,and honeycombs were evaluated(0–3 points).The dynamics of X-ray changes and PFTs was assessed in the general group and in pts with the prevalence of ILD up to 20%(group A,n=23) and more than 20%(group B, n=14). Results At the time of inclusion in the study,the total CT score of ILD on average for the group was 9.6±8.2.FVC was normal(94±19.5%);a moderate decrease in DLC was detected(57.3±20.2%).The prevalence of ILD significantly correlated only with the DLC(R=-0.35, p&lt;0.05). When included in the study,reticular changes were most often observed(the score was 4.6±3.5).Alterations by type of ground-glass were somewhat less common(the score was 3.2±3.1).The score of traction bronchiectases was 1.68±2.3.Changes by type of honeycombs were found in only 5 patients,of which only 1 patient was from the group A. Against the background of IST,values of FVC and DLC remained stable in the group as well as in the groups A and B,and the total CT score did not change.In patients of the group B,both the total CT score and the average score of ground-glass and reticular changes,and traction bronchiectases score were significantly higher. To assess the clinical significance of various X-ray symptoms,a correlation analysis of the total score of each of them with the PFTs data in groups A and B was executed. Table 1. Correlation DLC with CT score Group A Group B p DLC CT score R DLC CT score R &lt;0.05 DLC1 with total CT score 1 60.6±19.6 4.5±4.4 -0.5 47.6±11.4 18.1±5.6 -0.35 DLC2 with total CT score 2 62.6±19.1 4.1±3.9 -0.57 45.2±13.5 18.1±6.1 -0.47 DLC1 with reticular changes score 1 60.6±19.6 2.6±2.4 -0.44 47.6±11.4 7.9±2.4 -0.43 DLC2 with reticular changes score 2 62.6±19.1 2.7±2.3 -0.46 45.2±13.5 7.6±1.98 -0.51 DLC1 with bronchiectases score 1 60.6±19.6 0.5±1.2 (median-0 [0;0]) -0.54 47.6±11.4 7.8±2.0 -0.49 DLC2 with bronchiectases score 2 62.6±19.1 0.7±1.3(median-0 [0;1]) -0.6 45.2±13.5 7.6±2.0 -0.56 DLC1 with honeycomb score 1 - 47.6±11.4 1.3±2.3 (median-0 [0;1]) -0.34 DLC2 with honeycomb score 2 - 45.2±13.5 1.7±3.3(median-0 [0;1]) -0.34 “1”–at the time of inclusion in the study “2”–at the time of the last examination. No significant correlation between the score of X-ray signs and values of FVC was detected. DLC significantly inversely correlated with the total score of each HRCT symptom, with the exception of ground-glass.At the same time,strength of the correlation was approximately the same for reticular changes, bronchiectases, and honeycombs in both groups. Conclusion The severity of the alveolar-capillary membrane functional disorders is primarily due to the prevalence of fibrotic changes.The variant of fibrotic changes has no significant importance.Changes by type of ground-glass to a lesser extent affect the degree of reduction in DLC.The best surrogate indicator reflecting the prevalence of interstitial changes was DLC. Disclosure of Interests None declared